Agressive Behavior in Patients with Dementia

There seems to be an increase in the amount of agressive behavior in patients with Dementia or Alzheimer's disease and families are struggling to understand how to deal with these behaviors.  I usually hear families say "I don't know why my father is behaving like this he was never agressive".   Families still don't understand Dementia let alone the serious issues of agressive behavior. 

Why do some patient's with Dementia develop agressive behavior and other's don't?  What causes this behavior?  And what can be done to control this behavior?  These are some of the most understood issues with this disease. 

First families need to understand that it is not the person but the disease causing the agressive behavior.  Usually this type of behavior occurs when the frontal lobe of the brain is affected by the disease Dementia.  The frontal lobe is where a person's personality and behavior sit within the brain. Some people with dementia involving the frontal lobe undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use and understand language. It is important to have your loved one evaluated by a Neurologist or Neuropsychiatrist who specializes in Dementia in adults.  Once the right diagnosis is made then the patient can be treated appropriately and the family can be educated on what to expect with this very unpredictable illness.  

The signs and symptoms of this disease often vary from patient to patient.  It becomes progressively worse over time requiring 24 hour care.  Most behavioral changes that a person exhibits are;

Increasingly inappropriate actions

Loss of empathy and other interpersonal skills

Lack of judgment and inhibition

Apathy

Repetitive compulsive behavior

A decline in personal hygiene

Changes in eating habits, predominantly overeating

Lack of awareness of thinking or behavioral changes

Sudden Agression

Behavior can change without any warning

Once a person has been appropriately diagnosed treatment usually begins with using Antidepressants.  It is usually a long process to find the right combination of medications needed to manage the symptoms.  Often Antipyschotic drugs are needed but they can have adverse affects that need to be closely monitored because of the increased mortality in the elderly. 

The more that families understand about the illness they can better manage their own behavior around the person with the illness. Families and caregivers can reduce behavior problems by changing the way they interact with the person who has agressive behavior with dementia. Examples include:

• Avoiding events or activities that trigger the undesirable behavior (sometimes easier said than done).
• Anticipating needs and alleviating them promptly
• Maintaining a calm environment
• If the person is telling a story you know if not true don't try to correct them or tell them it is not true.  Just listen and redirect the individual. 
• Try to stick to routines.
• Never assume the individual will not exhibit a specific symptom, remember the behavior can happen without warning. 

Caring for someone with this type of  dementia can be challenging and stressful because of the extremes of personality changes and behavioral problems that develop. Family caregivers and family members need the support of their friends and professionals. Support groups provide a safety net for many family caregivers.  Put together a care plan that involves not only professional help but also help from others in your community such as church groups.  Often care provided by adult care centers or In-home care agencies are necessary to provide respite to the family.  When the person is end stage with their disease be sure to seek the support of Hospice care. 

Living with a person with Dementia or Alzheimer's disease is a 24 hour a day job.  Caring for a person with Agressive behavior associated with the disease there just aren't enough hours in a day.  So reach out to others for help.  More more information on Agressive behavior contact us at Family Caregivers Network.  We can direct you to the right help you need.  For anyone who believes they can handle it by themselves or doesn't think it will ever get that bad read the attached article;
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